The role of topotecan in cancer ginecology treatment
https://doi.org/10.17650/1994-4098-2016-12-4-52-56
Abstract
The high morbidity, often latent, asymptomatic disease development is not optimal therapy in the first line, causes the development of the frequent recurrence of tumors, requiring second and thirds lines of chemotherapy. The use of topotecan in standard mode is limited by myelosuppression, therefore the new regimes are studied. To reduce the hematologic toxicity is recommended weekly injection of 4 mg/m2 in 1, 8, 15 days of a 28-day cycle of therapy, as its effectiveness is comparable to the effectiveness of the standard 5-day regime. We determined the toxicity and efficacy of combined weekly topotecan and bevacizumab in patients with secondary platinumresistant ovarian, peritoneal, fallopian tube, endometrium and cervix cancer. Patients were treated topotecan 3,5–4 mg/m2 and bevacizumab 7 mg/kg on days 1, 8, and 15 of a 28-day cycle until progressive disease or excessive toxicity. The primary end point was efficacy and toxicity.
Combination on weekly topotecan and bevacizumab showed acceptable toxicity and encouraging efficacy in patients with platinum-resistant tumors.
About the Authors
A. G. Kedrova
Institute for Advanced Training, Federal Biomedical Agency of Russia;
Federal Research and Clinical Center, Federal Biomedical Agency of Russia
Russian Federation
Russian Federation
Department of Obstetrics and Gynecology, 91 Volokolamskoe Shosse, Moscow 125371;
Department of Oncology, 28 Orekhovyy Boulevard, Moscow 115682
V. V. Kosyy
Federal Research and Clinical Center, Federal Biomedical Agency of Russia
Russian Federation
Department of Oncology, 28 Orekhovyy Boulevard, Moscow 115682
Russian Federation
Department of Oncology, 28 Orekhovyy Boulevard, Moscow 115682
D. A. Astakhov
Federal Research and Clinical Center, Federal Biomedical Agency of Russia
Russian Federation
Department of Oncology, 28 Orekhovyy Boulevard, Moscow 115682
Russian Federation
Department of Oncology, 28 Orekhovyy Boulevard, Moscow 115682
References
1. Global Oncology Trend report. Developments in cancer. ASCO 2015.
2. Злокачественные новообразования в России в 2015 году. Под ред. А.Д. Каприна, В.В. Старинского, Г.В. Петровой. М., 2017. [Malignant neoplasms in Russia in 2015. Eds. by А.D. Kaprin, V.V. Starinskiy, G.V. Petrova. Мoscow, 2017. (In Russ.)].
3. Inima M., Banno K., Okawa R. et al. Genome wide analysis of gynecologic cancer: The Cancer Genome Atlas in ovarian and endometrial cancer (Review). 2016. DOI: 10.3892/ol.2017.5582.
4. Köbel M., Bak J., Bertelsen B.I. et al. Ovarian carcinoma histotype determination is highly reproducible, and is improved through the use of immunohistochemistry. Histopathology 2014;64(7):1004–13.
5. Eisenhauer E.A., Vermorken J.B., van Glabbeke M. Predictors of response to subsequent chemotherapy in platinum pretreated ovarian cancer: a multivariate analysis of 704 patients. Ann Oncol 1997;8(10):963–96.
6. Ledermann J.A., Kristeleit R.S. Optimal treatment for relapsing ovarian cancer. Ann Oncol 2010;21 (suppl. 7):218–22.
7. Engelholm S., Gronlund B., Horvath G. et al. Secuential topotecan and oral etoposide in recurrent ovarian carcinoma pretreated with platinum-taxane. Cancer 2005;103(7): 1388–93.
8. Herben V.M.M., ten Bokkel Huinink W.W., Beijnen J.H. Clinical pharmacokinetics of topotecan. Clin Pharmacokinet 1996;31: 85–102.
9. Speyer J., Hochster H., Wadler S. et al. Effective first line therapy of ovarian cancer with cisplatin and prologned topotecan infusion: a NYGOG/ECOG study. In: Program and abstracts of the American Society of Clinical Oncology 36th Annual Meeting; May 20–23, 2000; New Orleans, Louisiana. Abstr. 1503.
10. Frumovitz M., Munsell M.F, Burzawa J.K. et al. Combination therapy with topotecan, paclitaxel, and bevacizumab improves progression-free survival in recurrent small cell neuroendocrine carcinoma of the cervix. Gynecol Oncol 2017;144(1):46–50.
11. Traina T.A., Sabbatini P., Aghajanian C. et al. Weekly topotecan for recurrent endometrial cancer: a case series and review of the literature. Gynecol Oncol 2004;95(1):235–41.
12. Ahmad T., Gore M. Review of the use of topotecan in ovarian carcinoma. Expert Opin Pharmacotherapy 2004;5:2333–40.
13. McGonigle K.F., Muntz H.G., Vuky J. et al. Combined weekly topotecan and biweekly bevacizumab in women with platinum-resistant ovarian, peritoneal, or fallopian tube cancer: results of a phase 2 study. Cancer 2011;117(16):3731–40.
14. Ten Bokkel Huinink W., Gore M., Carmichael J. et al. Topotecan versus paclitaxel for the treatment of recurrent epithelial ovarian cancer. J Clin Oncol 1997;15:2183–93.
15. Московская Е.Ю. Топотекан в лечении рецидивов рака яичников. Дис. … канд. мед. наук. М.: МНИОИ им. П.А. Герцена, 2014. [Moskovskaya E.Yu. Topotecan in treatment of relapse ovarian cancer. Thesis of candidate of medical sciences. Мoscow: P.A. Herzen Moscow Oncology Research Institute, 2014. (In Russ.)].
16. Sehouli J., Stengel D., Oskay-Oezcelik G. et al. Nonplatinum topotecan combinations versus topotecan alone for recurrent ovarian cancer: results of a phase III study of the North-Eastern German Society of Gynecological Oncology Ovarian Cancer Study Group. J Clin Oncol 2008;26(19): 3176–82.
17. Gordon A.N., Fleagle J.T., Guthrie D. et al. Recurrent epithelial ovarian carcinoma: a randomized phase III study of pegilated liposomal doxorubicin versus topotecan. J Clin Oncol 2001;19(14):3312–22.
18. Safra T., Berman T., Yachnin A. et al. Weekly topotecan for recurrent ovarian, fallopian tube and primary peritoneal carcinoma: tolerability and efficacy study – the Israeli experience. Int J Gynecol Cancer 2013;23(3):475–80.
19. Edwards S.J., Barton S., Thurgar E. et al. Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for advanced recurrent or refractory ovarian cancer: a systematic review and economic evaluation. Health Technol Assess 2015;19(7):1–480.
20. Aijaz A., Patel D., Puccio C. et al. A pilot trial of docetaxel, topotecan and filgrastim (GCSF) in patients with recurrent epithelial cancer of the ovary and peritoneum. Proc. ASCO, 2000, v. 19, 407a, abstr.1612.
21. Peng L.H., Chen X.Y., Wu T.X. et al. Topotecan for ovarian cancer. Available in The Cochrane Database of Systematic Reviews; Issue 2. Chichester: John Wiley; 2008 (accessed 08/05/08).
22. Kim M., James J., Annunziata C.M. Topotecan synergizes with CHEK1 (CHK1) inhibitor to induce apoptosis in ovarian cancer cells. BMC Cancer 2015;15:196–201.
23. Sehouli J., Hilpert F., Mahner S. et al. Topotecan (T) ± sorafenib (S) in platinum-resistant ovarian cancer (PROC): A double-blind placebo-controlled randomized NOGGO–AGO intergroup Trial–TRIAS. J Clin Oncol 2016;34 (suppl; abstr. 5522).
24. Kitai Y., Kawasaki T., Sueyoshi T. et al. DNA-Containing Exosomes Derived from Cancer Cells Treated with Topotecan Activate a STING-Dependent Pathway and Reinforce Antitumor Immunity. J Immunol 2017 Jan 9. pii: 1601694. DOI: 10.4049/jimmunol.1601694.
Review
For citations:
Kedrova A.G., Kosyy V.V., Astakhov D.A. The role of topotecan in cancer ginecology treatment. Tumors of female reproductive system. 2016;12(4):52-56. (In Russ.) https://doi.org/10.17650/1994-4098-2016-12-4-52-56
Views:
785
Email this article 